Urban transport infrastructure planning and the public interest: a public health perspective.

OBJECTIVE: Transport infrastructure impacts public health. WestConnex in Sydney, New South Wales (NSW), is Australia's largest and most expensive transport infrastructure project. Concerns about the motorway project resulted in a NSW parliamentary inquiry into the project's impacts. Submissions to the inquiry were analysed to investigate their emphasis on health impacts and the cost-benefit analysis underpinning the project's business case. STUDY TYPE: Quantitative content and qualitative thematic analysis. METHODS: There were 556 submissions made to the inquiry into the impact of the WestConnex project. The content of a random sample of 93 (20%) of the individual submissions was analysed to identify health concerns. A purposive sample of 81 submissions by named groups including political parties and organisations was analysed separately (15% of the total submissions). RESULTS: Most individual submissions (63%) mentioned at least one aspect of health. Air pollution and children's health were the most frequently mentioned health issues. In the purposive sample, most submissions (64%) concerned the cost-benefit analysis (CBA), including concerns that the health impacts were being underestimated and economic benefits overestimated in the CBA. CONCLUSIONS: This study on the WestConnex project demonstrates how health impacts require early consideration within business cases for urban infrastructure projects, and later during environmental impact assessment. Systems for communicating and involving the public in decision making need to be improved, alongside greater transparency in CBA early in the project planning cycle.